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[聚乙二醇干扰素α治疗HBeAg阳性慢性乙型肝炎的HBV基因型及肝脏组织学效应]

[HBV genotype and liver histology effect of peginterferon alpha treatment of HBeAg-position chronic hepatitis B].

作者信息

Lu Chuan-Tong, Gao Guo-Sheng, Yan Hua-Dong, Hu Yao-Ren

机构信息

Ningbo Information Center and Ningbo Second Hospital, China.

出版信息

Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2013 Jun;27(3):193-5.

PMID:24319954
Abstract

OBJECTIVE

To investigate the efficacy of PEG-interferon alpha (PEG-IFN alpha) treatment of HBeAg-positive chronic hepatitis B and HBV genotypes and liver tissues effect of HBeAg seroconversion.

METHODS

54 cases confirmed by liver biopsy, genotype clear HBeAg positive chronic hepatitis B (CHB) patients according to body weight, respectively, subcutaneous injection of PEG-IFN-alpha2a 135 microg or 180 microg, or PEG-IFN-alpha2b 50 microg, 80 microg or 100 microg once weekly treatment for 48 weeks and followed for 24 weeks after discontinuation. Statistics of HBeAg seroconvertion, HBV genoty pes and liver histology e antigen seroconversion after the end of treatment.

RESULTS

54 patients were followed up at the end of HBeAg seroconversion rate was 29.63% (16/54). Genotype B patients with HBeAg seroconversion rate was 35.29%, 27.03% higher than the C-type patients, but the difference was not statistically significant (chi2 = 0.382, P = 0.537). Inflammation of the liver activity highter ( > G2) , the degree of fibrosis heavier ( > S1) HBeAg seroconversion rate (50.00% vs. 25.00%, 40.90% vs. 21.88%), but were not statistically significant (chi2 = 1.391, 1.444, P = 0.238, 0.229). Activity of HBV genotype, liver inflammation, liver fibrosis and other factors by multivariate Logistic regression analysis, only liver inflammation activity of the important factors of HBeAg seroconversion.

CONCLUSION

Important factors, liver inflammation activity of PEG-interferon alpha treatment of HBeAg-position chronic hepatitis B patients and HBV genotypes and liver fibrosis may be of little significance.

摘要

目的

探讨聚乙二醇干扰素α(PEG-IFNα)治疗HBeAg阳性慢性乙型肝炎的疗效以及HBV基因型和肝组织对HBeAg血清学转换的影响。

方法

54例经肝活检确诊、基因型明确的HBeAg阳性慢性乙型肝炎(CHB)患者,根据体重分别皮下注射PEG-IFN-α2a 135μg或180μg,或PEG-IFN-α2b 50μg、80μg或100μg,每周1次,治疗48周,停药后随访24周。统计治疗结束后HBeAg血清学转换、HBV基因型及肝组织学e抗原血清学转换情况。

结果

54例患者随访结束时HBeAg血清学转换率为29.63%(16/54)。B基因型患者HBeAg血清学转换率为35.29%,高于C基因型患者的27.03%,但差异无统计学意义(χ2 = 0.382,P = 0.537)。肝脏炎症活动度较高(>G2)、纤维化程度较重(>S1)的患者HBeAg血清学转换率较高(50.00% 对25.00%,40.90% 对21.88%),但均无统计学意义(χ2 = 1.391,1.444,P = 0.238,0.229)。经多因素Logistic回归分析HBV基因型、肝脏炎症、肝纤维化等因素,只有肝脏炎症活动度是HBeAg血清学转换的重要因素。

结论

肝脏炎症活动度是PEG-IFNα治疗HBeAg阳性慢性乙型肝炎患者HBeAg血清学转换的重要因素,而HBV基因型和肝纤维化可能意义不大。

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